影响脊髓损伤患者出院时日常生活活动能力的相关因素分析

目的 探讨影响脊髓损伤(SCI)患者出院时日常生活活动(ADL)能力的相关因素.方法 对105例SCI患者进行分析,入选时收集每位患者病史,记录一般情况如性别、年龄、病因、损伤水平、损伤分级、受伤(发病)时间、手术时间、入院和出院时间等,并记录出院和入院时的改良Barthel指数(MBI)评分、美国脊髓损伤协会(ASIA)SCI积分,对影响患者出院时ADL能力的因素进行线性回归分析.结果 出院时,SCI患者ASIA运动评分、ASIA针刺觉评分、ASIA轻触觉评分和MBI评分均有改善,与入院时比较,差异有统计学意义(P＜0.01);多因素分析显示,SCI分级、入院时ASIA运动评分、入院时ASIA针刺觉评分等3个因素与出院时MBI评分密切相关,康复介入时间、康复疗程、入院时ASIA运动评分等3个因素与出入院MBI差值密切相关.结论 通过康复训练,各年龄阶段、不同损伤平面、不同损伤程度的SCI患者的ADL能力都可得到改善.入院时运动能力较好、康复疗程足够长、康复介入时间早的患者改善幅度也相对较大.

Factors influencing functional recovery in patients with spinal cord injury at discharge

Objective To explore the factors influencing the functional recovery of patients with spinal cord injury (SCI) at discharge. Methods A total of 105 patients with SCI admitted to the rehabilitation medicine department at Huashan Hospital between December 2004 and October 2009 were studied. Data on eleven variables were collected including the patients' medical history, physical examination results and American Spinal Injury Association (ASIA) scores at admission. Functional status was registered according to the modified Barthel index (MBI) assessed at admission and before discharge. Linear regression analysis was used to assess the influence of the variables.Results After rehabilitation, average MBI and ASIA scores were significantly higher. The multiple regression analysis revealed that injury grade, motor and pinprick sensation scores at admission were related to MBI before discharge.The duration of rehabilitation, the rehabilitation treatment course and motor scores at admission were related to MBI increases during hospitalization. Conclusions Patients with different ages, injury levels and severity can improve their functional abilities through rehabilitation treatment, especially patients with better initial motor ability, longer treatment and earlier intervention.